Glenn A Roosevelt

NPI 1336285964 - Social Worker - 104100000X

NPI Details
NPI 1336285964
Gender Male
Enumeration Date 01/30/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
758 S 1ST ST
LOUISVILLE KY, 40202-2023, US
Phone (502) 589-1100
Fax (502) 589-8771
Business Location
101 W MUHAMMAD ALI BLVD
LOUISVILLE KY, 40202-1423, US
Phone
Fax
Toxanomy
Taxonomy Code 104100000X
License State Kentucky
License Number 105
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According to our database, Glenn A Roosevelt NPI is 1336285964, taxonomy code is 104100000X and license number is 105, license state is located at Kentucky. Glenn A Roosevelt physically located at 758 S 1st St, Louisville KY, 40202-2023. NPI Number Glenn A Roosevelt has the Individual type.

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1336285964 NPI number is provided on an as is basis without warranty of any kind. 1336285964 is maintained by the National Plan & Provider Enumeration System. The contents of Glenn A Roosevelt are for informational purposes only.